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Author Topic: What motivates judges to deny so many claims?  (Read 5783 times)

sosadwaiting

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Re: What motivates judges to deny so many claims?
« Reply #15 on: February 16, 2019, 03:22:24 pm »
Since we apparently posted at the exact same second I just read what you wrote... you do not have to go into such detail or try to convince me of her disability.  I believe you.  But you are missing the point 100%.

You must have medical documentation for a substantial and consistent period of time by an “approved” specialist, a Phyciatrist in this case, at the very least that backs up everything.   Period.  You are banging your head against a brick wall trying to explain to me or anyone her symptoms.

I believe just from what you wrote that your children are being adversely effected by her condition and may even be in danger depending on their ages.  No child should be left unattended like that. Your wife can get out of the tub if she hears screaming?  Are you serious?  Do you understand the potential ramifications of what you are saying?


Added after initial post:

Whoa.  Did you say part of the reason she got off (medication?) was so you could have another child because the medication is bad for the unborn?  Oh H** no please correct that as written if that’s not what you meant because having that severe of a phycological disorder that children are left unattended for that amount of time is inexcusable to chose to have another one unless other steps are put in place such as hiring a full time babysitter or nanny to be in the house at all times.  It only takes one minute for a child to get outdoors and disappear.

I really hope and pray your wife and family get the help she needs.  Sincerely. 
« Last Edit: February 16, 2019, 03:52:22 pm by sosadwaiting »

Sarasa Gold

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Re: What motivates judges to deny so many claims?
« Reply #16 on: February 16, 2019, 04:02:31 pm »
Admin, mods?

Possible to remove prior commenters content regarding OP's children?

Unacceptable IMHO.

"If you don't stand for something, you'll fall for anything"

Sarasa Gold

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Re: What motivates judges to deny so many claims?
« Reply #17 on: February 16, 2019, 04:04:50 pm »
I see not "OP", but yeah...Still.


Octaviar

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Re: What motivates judges to deny so many claims?
« Reply #18 on: February 16, 2019, 04:07:21 pm »
It’s not the Op, I’m the op and this thread has shifted direction radically.  In response however I did have one thought for Joshua, have you considered installing a bode’?  Not sure of spelling but an opportunity to wash herself quickly might help with the issue.  Just a thought. 
Conditions: migraines, ddd, major depressive disorder, PTSD, generalized anxiety disorder.
Initial application: 6-2014
Alj hearing and denial: 12-2016
Appeals council denial: 12-2017
Filed federal appeal: 2-2018
Federal Judge reversal: 6-2019
Backpay: 11-2019 (Award letter 12-2019)

Just Me

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Re: What motivates judges to deny so many claims?
« Reply #19 on: February 16, 2019, 04:10:49 pm »
Her getting off the medications does not look.good. Her having children when she cannot properly care for them is not good for her or the children. Children need to be watched. Even at the age your children are. There is so much that could happen while she is in the bathroom for hours. Things she might know nothing about until she comes out and discovers them.


If CPS has not been called. I am surprised. The children telling a teacher or anyone else how long they are left unsupervised. Is enough for CPS to make a home visit. The reason they are left unsupervised does not matter when it comes to their safety and well being. When she is in the shower for hours. Who feeds the children ? 

Her getting off her medications to have another child can be viewed in several ways. Her impairments are not as severe as she states. (Which is backed up my lack of consistent medical treatment) It is also backed up by the type of care a infant and toddler and young child require (diapers, toilet training) And her ability to give that care to more than one child at a time. Having children is more of a priority than getting better.

It is common for ALJ's to look.closer at cases where young mothers have young families. Especially when the children were born after the impairments presented. Unfortunately, some see disability as a way for them to be stay at home moms. I am not saying your wife is doing this. But the evidence, or lack of it could be. 

Nerve damage in upper and lower extremities. Degenerative Disc Disease, RA.

Hope the size of a mustard seed can produce Faith that can move mountains.

sosadwaiting

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Re: What motivates judges to deny so many claims?
« Reply #20 on: February 16, 2019, 04:14:53 pm »


The main topic posted was pretty vague to begin with, “what motivates judges to look at various information” loosely quoted...   not sure how this is all off topic since the commentary has been specifically on that very issue w/ Joshua’s case and how/why he believes the Judge “cherry picked” through his facts.   Maybe be more specific in your next post asking a question.




Sarasa Gold, Octavian ~ Joshua2001 was the one who brought the children up from his very first post, specifically about the Judges statements about the kids.  I never ever would comment on children out of nowhere I was addressing his own comments.

If he didn’t want them brought up he should have left them out.  If you followed the entire string of his you will see this.  Additionally it is irresponsible to at the very least not point out the obvious dangers in their situation maybe he’s never looked at it that way and will address what is by his own description a dangerous situation.  This is an anonymous website and I’m pretty sure his kids aren’t reading this.

How anyone can let the situation pass out of “civility” is wrong.  Clearly the Judge thought so too.  You do not mess around with or ignore the children’s safety because it’s not “polite”, or however you are perceiving it.  They are small children being left unattended.
« Last Edit: February 16, 2019, 04:29:24 pm by sosadwaiting »

Sarasa Gold

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Re: What motivates judges to deny so many claims?
« Reply #21 on: February 16, 2019, 04:21:03 pm »
Sorry Joshua. You seem to be carrying a lot of weight and must be very strong. Stay that way. I hope you find relief and get the help you seek.

Thanks for all the info, SSDFacts. Sarasa Out.

Octaviar

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Re: What motivates judges to deny so many claims?
« Reply #22 on: February 16, 2019, 04:21:30 pm »
Sosadwaiting:  I believe you meant the above comment for someone else.
Conditions: migraines, ddd, major depressive disorder, PTSD, generalized anxiety disorder.
Initial application: 6-2014
Alj hearing and denial: 12-2016
Appeals council denial: 12-2017
Filed federal appeal: 2-2018
Federal Judge reversal: 6-2019
Backpay: 11-2019 (Award letter 12-2019)

sosadwaiting

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Re: What motivates judges to deny so many claims?
« Reply #23 on: February 16, 2019, 04:54:42 pm »
Octaviar I thought you said that this string has shifted radically and you were the Original Poster..  sorry if I read that wrong?

I simply meant to whoever wrote that I didn’t think the original topic shifted much at all as it was a pretty vague question/topic to begin with.

What sways a Judge?  Who knows. Maybe s/he’s sick, or tired, or grumpy.  But more often then not it’s applicants not understanding the process, for example..

One thing I’ve learned in almost 10- years is it definitely helps to have a local lawyer, one who only practices in that courtroom and therefore knows all of the players probably even on a personal level, and being proactive as the applicant in getting all of your medical documentation to that lawyer as soon as you can. 

People that chose to go it on their own without a lawyer make so many mistakes.  The most common one submitting “thousands” of pages of medical crap, I mean documentation..  not necessary most of the time and all it does is irritate the Judge and his staff and add to your wait time. A lot.  Weeks even months.  A good lawyer who knows the Judge will know what to submit, or if you don’t have the proper documentation will advise you what to do.

The rules are actually pretty simple but people’s emotions get the best of them and muddle things up.  Hire the local lawyer..

newdawn

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Re: What motivates judges to deny so many claims?
« Reply #24 on: February 16, 2019, 07:32:58 pm »
People that chose to go it on their own without a lawyer make so many mistakes.  The most common one submitting “thousands” of pages of medical crap, I mean documentation..  not necessary most of the time and all it does is irritate the Judge and his staff and add to your wait time. A lot.  Weeks even months.  A good lawyer who knows the Judge will know what to submit, or if you don’t have the proper documentation will advise you what to do.

I agree with parts of your post but I want to clarify that the claimant and any lawyer/rep/advocate is required to submit ALL evidence relating to their disability and the relevant time period.

SSA even published clarification on this in 2015:

"We are clarifying our regulations to require you to inform us about or submit all evidence known to you that relates to your disability claim, subject to two exceptions for certain privileged communications. This requirement includes the duty to submit all evidence that relates to your disability claim received from any source in its entirety, unless you previously submitted the same evidence to us or we instruct you otherwise."

...

"In addition, we expect claimants to exercise their reasonable, good faith judgment about what evidence “relates” to their disability claims keeping in mind, however, that the meaning of “relates” is broad and includes anything that has a logical or causal connection whether it is favorable or unfavorable to the claim. It is also important to note that we consider all of a claimant's impairments for which we have evidence, not just the ones alleged,[3] and we consider the combined effect of all impairments.[4] We are also required, subject to certain exceptions, to develop a complete medical history for at least the 12 months preceding the date of the disability application.[5] Therefore, evidence of treatment for conditions other than the one alleged by the claimant could relate to the disability claim. For example, if a claimant alleged a back impairment, the treatment records from health care providers other than the treating orthopedic surgeon (for example, from a family doctor who has rendered treatment for a condition other than the one alleged) may contain related information. Therefore, we may ask the claimant if he or she saw other providers during the period at issue....

"However, we would expect our adjudicators to exercise their reasonable, good faith judgment when requesting information or evidence from claimants. For example, we would not require a claimant to disclose treatment for a health matter such as an abortion, if the claimant alleged disability based on a genetic disorder."

https://www.federalregister.gov/documents/2015/03/20/2015-05921/submission-of-evidence-in-disability-claims

As usual, the Final Rule published in the Federal Register addresses point by point commentors who didn't like parts of the proposed rule for whatever reason. Final Rules are usually an interesting read and written so that a lay person can get the gist of things.

I believe there was an issue in the past (and probably still) with some national firms and lawyers being accused of picking and choosing which evidence to submit based on what the firm or lawyer thought would be most favorable to the claim and withholding "unfavorable" evidence.

Anyways, my point is:

I agree that some people submit records that are unnecessary, e.g. duplicative records, records going way too many years back in time prior to their AOD, and maybe a few that submit records totally unrelated to their disability like the abortion example provided in the Final Rule. (Though there may be some cases where the abortion record might have evidence that "relates" to the disability, so who knows.)

And a claimant or lawyer/rep should certainly put on the top of the stack (or cite) the most pertinent evidence that would lead to the quickest path to approval. And though I can't speak from the experience of an ALJ or a practicing lawyer/rep, I don't think it will affect a claim negatively to submit all evidence in its entirety as long as it's approx a year or two prior to the AOD and relates to the disability claim, especially if the claimant or lawyer/rep highlights the key piece(s) of medical evidence in some way and especially considering the history of alleged fraud and alleged withholding of evidence.

For example, from the original Proposed Rule:

"There has been recent public and media interest in what our regulations require regarding the submission of evidence in disability claims, particularly regarding the duty to submit unfavorable evidence. There have been allegations that when some representatives submit evidence to us, they deliberately withhold evidence they deem unfavorable to the claimant. We also know, based on our program experience, that we do not always receive complete evidence. This public and media interest has drawn congressional attention.[3] In particular, members of Congress have asked about the relationship between the Social Security Protection Act of 2004 (SSPA) and the duty to submit potentially unfavorable evidence in disability claims. The SSPA authorized us to penalize a person who withholds a fact, which the person knows or should know is material to the determination of any initial or continuing right to benefits. In light of congressional interest and our program experience, we have again reviewed our regulations that govern the submission of evidence."

https://www.federalregister.gov/documents/2014/02/20/2014-03426/submission-of-evidence-in-disability-claims
« Last Edit: February 16, 2019, 07:34:32 pm by newdawn »
Location: IL
Age at Application: 31
Disability: Depression, anxiety
Applied: 11/2013
First Denial: 03/2014
Reconsideration Denial: 11/2014
Hearing: 11/13/15 (Friday the 13th!)
ALJ Approval: 01/15/16 Fully Favorable
Back Pay: 02/13/16
Award Letter: 02/17/16
1st monthly benefit: 03/21/16

Joshua2001

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Re: What motivates judges to deny so many claims?
« Reply #25 on: February 16, 2019, 07:42:14 pm »
Sorry If this thread got hijacked a bit.  I still think this is on topic because it gives me insight into what the judge was likely thinking.  He likely ended up at a lot of the same assumptions and conclusion that you all here have made which caused him to cherry pick through the evidence.  He made his decision and went through the evidence to find quotes to beef it up.  Even if they were out of context. 

I also think the questions about my children were appropriate and something we have thought of ourselves.  Probably off topic for this thread but a good question none the less.  Suffice it to say we have that covered.  We have lots of people that help out. Neighbors, church members, and family.  I have FMLA to come home when needed and all of these people are less than 5 minutes away.  As far as near constant care goes I will have to disagree on that though.  I see that as more of a personal philosophical opinion on child care and rearing that I don’t really agree with you on.
Yes friends come over when she isn’t compulsing.  When she is they go home since they live next door and a lot of times our kids go with them.
We only have 2 kids and haven’t had any since she started having this problem during her pregnancy with our second.  She wants another one really bad but she needs to get to a point where she is doing well enough to care for the child.  And she would need to stop taking the medication again.  I am not really ready for that and I don’t think it would be good for her mental health or our children at this point.  To be clear she is currently on medication.  There was no way in hell I was going to allow her to stay off of it when she got so bad.  Not that she is that much better on it but it does help. 
As far as a lawyer not taking our case I don’t know for sure but suspect it was at least a few reasons.  I think the first lawyer dropped us because we didn’t have enough evidence on file.  At that point we only had her primary psychiatrist’s records and that was only 3 years’ worth.  We were totally clueless.  My wife then called around and most weren’t even taking clients and the ones that were I think were put off by the fact it was SSI so they wouldn’t really get paid much.  The first lawyer dropped as our hearing was getting scheduled so we didn’t really have much time.  Not to mention there wasn’t a lot of time before the hearing.  It wasn’t until just before the first hearing was postponed that we realized most of her records weren’t there and we started getting them sent in.  Some of them didn’t arrive until the day before the second hearing.  After the hearing I had her doctor submit an opinion to help out.  We were very unprepared.  I am sure that really irritated the judge and didn’t help our case.
And yes we do actually have quite a bit of evidence.  Enough that the ALJ had to find her condition serious.  He basically wrote off almost all of her symptoms at that point likely for the same reasons a lot of you here seem to be pointing out.  That is where his cherry picking came in.  He found any quote that supported his conclusion.  Even if they were taken out of context.
Just so there is no confusion, I appreciate you guys pointing this out.  It helps me to understand where the judge was likely coming from and if we get a remand where to focus our efforts.  Hopefully we will be able to get a lawyer at that point but if not we will be much more prepared. 
Oh and sorry OP.  I didn’t mean to hijack your thread but it is still kind of on topic.

sosadwaiting

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Re: What motivates judges to deny so many claims?
« Reply #26 on: February 16, 2019, 07:48:50 pm »
Newdawn. I stand corrected.  Actually it was an auto correct I meant to say “Many” People that chose to go it alone, not insinuate all people.

I’m just relaying what my attorney not only said but did..
there were approximately 10,000 pieces of paper/medical information that was sent in from various hospital stays in my case because they just send everything.  He threw away every page of in hospital hourly blood pressure/temperature checks, (about 200 pages right there), and tons of other routine crap.  Like I said, hire the lawyer let them decide they’re getting the $6,000.00 if you win backpay make them do something for it.

In no way was I suggesting people play around with their records however a lot of it is common sense.  Again, the lawyer should do it.

BUT when an applicant or bad lawyer doesn’t cull out that kind of information it IS annoying to the Judges staff because they are required to read every single page and document it.  Believe me (or my lawyer anyway) after culling through page after page of BP/Urine Amounts/Temps they get over it.

Actually the point is made right in the first paragraph you posted, all paperwork related to the disability..  so not necessary to be submitting years of OBGYN records with your kids births going back 20- years.  It happens all the time.  Or that tonsillectomy you had 15 years ago.  (all of those records were in my files totally irrelevant)
« Last Edit: February 16, 2019, 07:53:54 pm by sosadwaiting »

Just Me

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Re: What motivates judges to deny so many claims?
« Reply #27 on: February 16, 2019, 10:31:58 pm »
Didn't you say she got off her medication to have another child ? Were you referring to her second child ? If you were, why was she in medication if her condition had not presented ? Or were you referring to her getting pregnant with a third child ? If you were, why did she get off her medication if she knows she should not have another child until her condition improves? I'm sorry I am having trouble understanding.
Nerve damage in upper and lower extremities. Degenerative Disc Disease, RA.

Hope the size of a mustard seed can produce Faith that can move mountains.

newdawn

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Re: What motivates judges to deny so many claims?
« Reply #28 on: February 16, 2019, 10:48:53 pm »
Newdawn. I stand corrected.  Actually it was an auto correct I meant to say “Many” People that chose to go it alone, not insinuate all people.

I’m just relaying what my attorney not only said but did..
there were approximately 10,000 pieces of paper/medical information that was sent in from various hospital stays in my case because they just send everything.  He threw away every page of in hospital hourly blood pressure/temperature checks, (about 200 pages right there), and tons of other routine crap.  Like I said, hire the lawyer let them decide they’re getting the $6,000.00 if you win backpay make them do something for it.

In no way was I suggesting people play around with their records however a lot of it is common sense.  Again, the lawyer should do it.

BUT when an applicant or bad lawyer doesn’t cull out that kind of information it IS annoying to the Judges staff because they are required to read every single page and document it.  Believe me (or my lawyer anyway) after culling through page after page of BP/Urine Amounts/Temps they get over it.

Actually the point is made right in the first paragraph you posted, all paperwork related to the disability..  so not necessary to be submitting years of OBGYN records with your kids births going back 20- years.  It happens all the time.  Or that tonsillectomy you had 15 years ago.  (all of those records were in my files totally irrelevant)

Yes, I think we are mostly in agreement* now that I've read your post above which adds further detail to what you meant.

*FWIW, it's somewhat rare for me to ever say I'm 100% in agreement with anyone on anything when it comes to forum posts (any forum, not just SSDFacts), so I almost always hedge with a word like "mostly".

Also, sorry for adding to the thread derailments, but they're mostly on-topic in one way or another IMO. (There I go hedging with another "mostly". Guess I just can't commit.)
« Last Edit: February 16, 2019, 10:53:51 pm by newdawn »
Location: IL
Age at Application: 31
Disability: Depression, anxiety
Applied: 11/2013
First Denial: 03/2014
Reconsideration Denial: 11/2014
Hearing: 11/13/15 (Friday the 13th!)
ALJ Approval: 01/15/16 Fully Favorable
Back Pay: 02/13/16
Award Letter: 02/17/16
1st monthly benefit: 03/21/16

Joshua2001

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Re: What motivates judges to deny so many claims?
« Reply #29 on: February 16, 2019, 11:08:52 pm »
Her OCD went from a minor annoyance to full blown crazy during her pregnancy with our second child.  It was about half way through the pregnancy.  She did end up going on meds before the birth but it wasn’t something we took lightly.  We kind of felt like we didn’t have a choice.  She got so bad so fast that we didn’t know what to do.  It was about 3 or 4 years later that we decided we might want to give it another try but we didn’t want her on the medication while she was pregnant since our understanding was her medications aren’t safe especially in the early stages of pregnancy.  That never really materialized because she crashed again before we could start trying.  Haven’t tried since.  Our youngest turns 8 this year.  So no only 2 kids.